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EPIDEMIOLOGY AND CLINICAL ASPECTS OF ENTERIC FEVER IN ISRAEL

Enteric fever decreased in Israel in the last 50 years, but its current epidemiology is unknown. In a nationwide study, we evaluated all cases of enteric fever from 1995 to 2003. On hundred thirty-six cases met the case definition. During the period studied, the incidence of enteric fever decreased from 0.42 to 0.23/100,000. A total of 57.4% of the cases were acquired abroad. The incidence of endemic enteric fever was 2.7 times higher in Arabs than in Jews. In Arabs, Salmonella Typhi was the causative agent in all cases, and almost all cases were endemic. In Jews, most cases were imported, with a decrease in imported S. typhi, cases and an increase in imported S. Paratyphi A cases. Salmonella Paratyphi B was endemic, and restricted to the Jewish population. The reasons for the difference in causative agents along ethnic lines need further evaluation. A more efficient vaccine for travelers that includes S. Paratyphi A is needed.

Received December 2, 2004. Accepted for publication April 7, 2005.

^* Address correspondence to Eli Schwartz, Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel, E-mail: elischwa{at}post.tau.ac.il

Authors’ addresses: Eyal Meltzer and Eli Schwartz, Center for Geographic Medicine and Department of Medicine C, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel, Telephone: 972-54-472-8552 and 972-52-666-6132, Fax: 972-3-530-3501 and 972-3-350-2011, E-mails: emeltzer{at}post.tau.ac.il and elischwa{at}post.tau.ac.il. Orit Yossepowitch and Michael Dan, Infectious Disease Unit, E. Wolfson Medical Center, P.O. Box 5, Holon 58100, Israel, Telephone: 972-3-502-8729, Fax: 972-3-501-6126, E-mails: yossepowitch_o{at}netvision.net.il and midan{at}post.tau.ac.il. Chantal Sadik, Epidemiology Department, Ministry of Health, P.O. Box 1176, Jerusalem 91010, Israel. Telephone: 972-2-670-6814, Fax: 972-2-670-6876, E-mail: chantal_sadik{at}moh.health.gov.il.